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RIP The Baby Aspirin

Updated: Oct 13, 2021

by Al Lewis


The recommendation to take a daily baby aspirin (81 milligrams) as a blood thinner to prevent a heart attack or stroke has a long history. At one point, decades ago, it was totally a thing. At least until it wasn’t, when wiser minds than ours realized:


1. for lower-risk people, thinning the blood increased the likelihood and risk of bleeds more than the benefit of event avoidance; and

2. a little five-cent pill based on a 19th-century technology was not going to eliminate the #1 cause of death in America. (The cartoon below was published during the peak euphoria, needless to say.)



Fortunately, there is now an arbiter to prevent or at least dampen excessive enthusiasm and equally excessive backlashes, by painstakingly reviewing all the evidence in these situations: US Preventive Services Task Force (USPSTF). They are the official arbiter of all things preventive, and their recommendations are law when it comes to Medicare and the Affordable Care Act. (Recommended preventive interventions are costless to the patient.)


They offer five grades for preventive interventions:

In this case, USPSTF has just revised its the baby aspirin recommendation, by bestowing a "C" for people who believe (or whose doctors believe) they have a decent chance of a stroke or heart attack in the next ten years. (This does not apply to people who have already had one, or other patient-specific reasons to take these. Just for people who are trying to do "prevention."


People in their 60s get a “D” -- specifically because the risk of bleeding exceeds the benefit of avoided stroke and heart attack risk.


Next steps: urge your wellness vendor to revise their risk assessment. Quizzify will be incorporating a new question into our quizzes, starting now.




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